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Federalism, Party Competition and Budget Outcome: Empirical Findings on Regional Health Expenditure in Italy

Author

Listed:
  • Giardina, Emilio
  • Cavalieri, Marina
  • Guccio, Calogero
  • Mazza, Isidoro

Abstract

In the last decade, Italy has experienced a considerable decentralization of functions to the regions. This transformation has been especially relevant for the National Health System that has de facto assumed a federal system design. The federal reform aimed at disciplining public health expenditure, which drains a substantial share of the budget of Italian regions and is among the main causes of the regional deficits. Political economic analysis, however, suggests that impact of federalism on public expenditure depends on central and local government strategies to win in the electoral competition. Results derived in this preliminary study indicate that political competition actually works as a tool of fiscal discipline; it shows a restraining effect on public health expenditure.

Suggested Citation

  • Giardina, Emilio & Cavalieri, Marina & Guccio, Calogero & Mazza, Isidoro, 2009. "Federalism, Party Competition and Budget Outcome: Empirical Findings on Regional Health Expenditure in Italy," MPRA Paper 16437, University Library of Munich, Germany.
    • Handle: RePEc:pra:mprapa:16437
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    References listed on IDEAS

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    Cited by:

    1. Atella, Vincenzo & Belotti, Federico & Depalo, Domenico & Piano Mortari, Andrea, 2014. "Measuring spatial effects in the presence of institutional constraints: The case of Italian Local Health Authority expenditure," Regional Science and Urban Economics, Elsevier, vol. 49(C), pages 232-241.
    2. Nadia Fiorino & Emma Galli & Ilaria Petrarca, 2012. "Corruption and Growth: Evidence from the Italian Regions," European Journal of Government and Economics, Europa Grande, vol. 1(2), pages 126-144, December.

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    More about this item

    Keywords

    Fiscal federalism; local budget; multi-level policy-making; public expenditure; political competition; health economics;
    All these keywords.

    JEL classification:

    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • H72 - Public Economics - - State and Local Government; Intergovernmental Relations - - - State and Local Budget and Expenditures
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • D78 - Microeconomics - - Analysis of Collective Decision-Making - - - Positive Analysis of Policy Formulation and Implementation
    • D72 - Microeconomics - - Analysis of Collective Decision-Making - - - Political Processes: Rent-seeking, Lobbying, Elections, Legislatures, and Voting Behavior

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